Title Page

  • Date of Inspection

  • Inspected by

  • Exterior Photo

  • Is the house number visible from the street?

  • Are service entrance raceways or cables fastened in place, grounded, readily accessible and in good condition?

  • Are outside electrical receptacles GFCI and are they in good working condition?

  • Is the property free of the accumulation of rubbish, trash, brush or tree trimmings?

  • Are wood piles further than 30’ away from any building?

  • If Garage is detached, is a second fire extinguisher provided?

  • If Garage is attached is a firewall between the garage and house present and is it in tact?

  • Is there a solidcore door between the garage and residence?

  • Is gas powered equipment stored in an outside shed or garage, separate from the home?

  • Is gasoline stored in an approved safety container in an outside shed or garage, separate from the home?

  • Does the home have smoke alarms on every level?

  • Does the home have a smoke alarm in every bedroom?

  • Are smoke alarms are located outside each separate sleeping area?

  • Are smoke alarms are interconnected so when one sounds, they all sound?

  • Are all smoke alarms are working?

  • Have all Smoke Alarms been inspected for, and are free of, physical damage and are unexpired?

  • Do windows used for escape open easily?

  • Is there a fire extinguisher in the home?

  • Does the home have a fire extinguisher with a minimum rating of 2A?

  • Are the portable fire extinguishers mounted properly, accessible, and fully charged? Is the tamper seal intact, a valid contractor’s inspection tag present and are monthly visual inspections performed?

  • Does the home have carbon monoxide (CO) Detectors?

  • Do all rooms have 2 exit routes?

  • Are Flammable liquids, if stored in the home, limited in quantity?

  • The home is not cluttered with clothes, magazines, newspapers and other items that can burn?

  • There are no propane heating appliances, or other open burning appliances in the residence?

  • Does fireplace have a proper screen and hearth?

  • Is an ash can in place for fireplace cleaning?

  • Things that can burn are at least 3 feet from space heaters, fireplaces, and furnaces?

  • Do kitchen and bathrooms have GFCI outlets on counter top surfaces within 6 feet of running water outlets and they are working properly?

  • Are all receptacle and switch face plates are installed and in good condition?

  • Are surge protectors (power strips) being used properly?

  • Are lighting fixture canopies fastened in place and are fixture is in good condition? INTERIOR

  • Are lighting fixture canopies fastened in place and are fixture is in good condition? EXTERIOR

  • Are the bulbs in light fixtures the correct wattage for the lighting fixture?

  • Flexible cords and cables are NOT being used as fixed wiring, run through holes in walls, ceiling or floor, run through doorways or windows or under carpets or attached to building surfaces?

  • Is electrical panel and distribution equipment accessible and in good condition?

  • Does the building have a fire alarm system?

  • If a fire alarm system exists, can facility manager show proof of Inspection, Testing, and/or Maintenance?

  • Has the fire alarm system had an annual inspection/test?

  • Are the fire alarm system inspections conducted by a third party?

  • Is there a sprinkler system in the home?

  • Has this system been inspected by a competent person?

  • Do visual inspection of all sprinklers shows they are not blocked, or being used to support decorations, and are not leaking or damaged?

  • Are all water supply valves open, and secured in open position?

  • NOTES

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.